Provider Demographics
NPI:1023825031
Name:GONZALEZ PEREZ, MELINA MARINA (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:MELINA
Middle Name:MARINA
Last Name:GONZALEZ PEREZ
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 LILY LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-5588
Mailing Address - Country:US
Mailing Address - Phone:863-512-2141
Mailing Address - Fax:
Practice Address - Street 1:135 LILY LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-5588
Practice Address - Country:US
Practice Address - Phone:863-512-2141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036675363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily